Effects of prolonged transesophageal echocardiographic imaging and probe manipulation on the esophagus—An echocardiographic-pathologic study

Abstract

Transesophageal echocardiography is being increasingly utilized in the operating room and intensive care and ambulatory settings. However, to date no data are available concerning possible trauma of the transesophageal echocardiographic technique to the esophagus due to probe insertion, manipulation or direct ultrasound energy transmission. To test the hypothesis that transesophageal manipulations caused no traumatic or thermal injury to the esophageal mucosa, 12 animals were studied with continuous transesophageal echocardiography for a period of variable duration (mean 4.6 h +/- 51 min). The study group consisted of four monkeys (mean weight 5.7 +/- 0.6 kg and eight mongrel dogs (mean weight 29.8 +/- 1.4 kg). The eight dogs were studied during right heart bypass with full heparinization for 6.6 +/- 0.2 h, whereas the four monkeys were studied for 60 to 90 min in the absence of cardiopulmonary bypass and anticoagulation. Immediately after completion of transesophageal echocardiography in each case, the esophagus was entirely excised. Detailed macroscopic and microscopic examination of the esophagus revealed no significant mucosal or thermal injury. This preliminary animal study suggests that transesophageal echocardiography is safe for the esophageal mucosa in animals as small as 5 kg in weight, despite prolonged use and in the presence of systemic anticoagulation.

Measurement of cardiac output by transesophageal echocardiography in mechanically ventilated patients

“…This technique has been reported to be inaccurate in the determination of CO in critically ill patients with subarachnoid hemorrhage [15]. Transesophageal echocardiography is a minimally invasive method [16,17] that relies on high-frequency probes to improve resolution and thus provides high-quality images of cardiovascular structures [18]. This technique has been proposed for measuring CO from transmitral, transaortic and transpulmonary flows, especially during intraoperative cardiac function monitoring with discordant conclusions [19][20][21][22][23].…”

Segurança da ecocardiografia transesofágica em adultos: estudo em um hospital multidisciplinar

“…The literature has reported the presence of thermal lesions and bleeding in anticoagulated patients, and more rarely, mucosal damage in patients with Mallory-Weiss esophagitis [9][10][11] . The curling of the probe during handling is an unusual situation and can cause difficulty at the removal.…”

Transesophageal Echocardiography

“…Additional caution must be exercised when inserting the probe in dogs that weigh less than 5 kg. Studies have shown that TEE can be performed without risk in children and in small anticoagulated animals with an intact mucosa or minimal injuries [12,13], especially if the examinations are performed with appropriate training and caution. The authors have never observed any signs of esophageal trauma in performing 200 examinations.…”